title: Cases of difficult suture removal following the McDonald procedure.
abstract: We examined the clinical significance of difficult suture removal following the McDonald procedure. We examined 117 patients following the McDonald procedure with a singleton pregnancy who delivered at ≥34 weeks of gestation. Difficult suture removal was defined as when spinal anesthesia was required for suture removal. Seven patients (6.0%) were defined as involving difficult suture removal. The cervical length in the difficult-removal-group was significantly shorter than that in the easy-removal-group at suture removal (p = 0.04). If the cervical length was shorter than 20 mm, the odds ratio for difficult suture removal was 9.0 (95% CI 1.6-49, p = 0.01). The progression of cervical ripening following the McDonald suture may be associated with an increased risk of difficult suture removal.
authors.affiliation: Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital , Tokyo , Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D023802:Cerclage, Cervical / Q000009:adverse effects* / Q000379:methods*; D054791:Cervical Length Measurement; D020878:Device Removal / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007752:Obstetric Labor, Premature / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D012189:Retrospective Studies; D013536:Suture Techniques / Q000009:adverse effects* / Q000295:instrumentation; D013537:Sutures; D002581:Uterine Cervical Incompetence / Q000453:epidemiology / Q000601:surgery*
keywords: Cervical length; McDonald procedure; difficult suture removal